Children with overweight or obesity are 30% more likely to develop asthma and nearly twice as likely to develop wheezing symptoms when compared with children of normal weight, with a higher risk observed in girls vs. boys, according to findings from a meta-analysis published in Pediatric Obesity.
“Currently, the epidemiological relation between overweight or obesity and incident asthma remains inconsistent and inconclusive,” Wenquan Niu, PhD, of the Institute of Clinical Medical Services at China-Japan Friendship Hospital in Beijing, and colleagues wrote in the study background. “A majority of longitudinal studies have shown that being overweight and suffering from obesity precede the onset of [childhood] asthma, yet findings from other studies indicate that children with asthma or presence of asthma history may be at higher risk of obesity.”
In a meta-analysis, Niu and colleagues analyzed data from 18 prospective studies with 73,252 children assessing the association between asthma and asthma-related symptoms with overweight and obesity, conducted through October 2018. Overweight or obesity was defined according to U.S. sex- and age-standardized values (n = 8), the International Obesity Taskforce (n = 4), WHO criteria (n = 2), U.K. criteria (n = 2) and Taiwan standards (n = 2). Follow-up time ranged from 0 to 18 years. Researchers used random-effects models to estimate the effect size of overweight or obesity for the risk for asthma and related symptoms.
In pooled analyses, researchers found that overweight and obesity increased the risk for childhood asthma (OR = 1.3; 95% CI, 1.23-1.39) and wheeze (OR = 1.9; 95% CI, 1.38-2.63).
In subgroup analyses, children with obesity (OR = 1.4; 95% CI, 1.291.52) were more likely to have asthma vs. children with overweight (OR = 1.22; 95% CI, 1.141.31). In sex-stratified analyses, girls with overweight or obesity were more likely to have asthma vs. boys, with ORs of 1.34 (95% CI, 1.161.56) and 1.27 (95% CI, 1.151.4), respectively.
In analyses stratified by geographic region, researchers found that the association between overweight or obesity and asthma was strongest in the United States (OR = 1.31; 95% CI, 1.23-1.4) and in Europe (OR = 1.86; 95% CI, 1.3-2.66) when compared with other regions (OR = 1.07; 95% CI, 0.78-1.45).
“Our findings are biologically plausible, and several possible mechanisms may be involved in the connection between overweight or obesity and childhood asthma, such as obesity-related reduction in lung volume (mechanical effects of obesity) and changes in hormone, dyslipidemia and inflammatory mediators,” the researchers wrote. “Specifically, truncal adiposity can lead to decreased functional residual capacity, reduced residual volume and expiratory reserve volume, which might result in arduous breathing in subjects with obesity.” – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.